THE SECRET LIFE OF FAMILIES

A therapist's attempt to put the brakes on sharing intimate secrets with just anyone, including those millions who gape at afternoon talk shows. Imber-Black (Albert Einstein College of Medicine, Ackerman Institute for the Family) is a specialist in family therapy who sees both value and danger in keeping secrets but feels that our current reluctance to hide any skeletons at all in the closet ignores ``the complicated consequences to our relationships'' of letting ``it all hang out.'' She begins by defining various kinds of secrets, including ``sweet secrets'' (e.g., birthday surprises); ``essential secrets'' (intimacies between wife and husband that healthily define self and relationships); ``toxic secrets'' (family suicides, abortions); and ``dangerous secrets'' (sexual abuse, drug abuse). She also carefully defines the distinction separating secrecy from privacy, one that is both ``critical and slippery.'' The taboos that seem to demand secrecy are changing, she alleges, with divorce, adoption, and mental illness no longer considered shameful, while homosexuality, AIDS, and domestic violence are still under cover. Perhaps most alarming, though, is the author's discussion of ``institutional secrets,'' ranging from medical experiments such as the Tuskegee syphilis project to the increasing intrusion of managed-care administrators into the doctor-patient relationship. Unveiling secrets should take place as a well-guarded and thought-out process, says Imber-Black. For sometimes randomly spewing out secrets, as on talk shows, results in long-term pain, unprotected by a therapist or other caring person. Moreover, someone who has no secrets risks obliterating ``any sense of individuality.'' The author urges caution before releasing a secret to the marketplace: Whom will it benefit? Does everyone really have to know all about it? The point: No single criterion exists for deciding to share or not to share, but when shame or fear throw up barriers to essential personal development, that's the right time to show and tell.